Nocturnal Supervision May Have Protective Effect in SUDEP

Limited evidence suggests supervision at night may reduce sudden unexpected death in epilepsy

FRIDAY, April 10, 2020 (HealthDay News) — There is limited, very low-certainty evidence of a protective effect for nocturnal supervision against sudden unexpected death in epilepsy (SUDEP), according to a report published online April 2 in the Cochrane Database of Systematic Reviews.

Melissa J. Maguire, M.B.Ch.B., M.D., from Leeds General Infirmary in the United Kingdom, and colleagues examined the effectiveness of interventions in preventing SUDEP in people with epilepsy. Data were reviewed from one cohort study and three case-control studies.

The researchers identified no significant effect for providing patients with SUDEP information on drug compliance and quality of life, anxiety, and depression levels in the six-month prospective cohort study. Two case-control studies indicated a protective effect for nocturnal supervision against SUDEP. The results could not be included in the meta-analysis due to significant heterogeneity. In one study with 154 SUDEP cases and 616 controls, the unadjusted odds ratio was 0.34. In the same study, the protective effect was found to be independent of seizure control. In the second case-control study with 48 SUDEP cases and 220 controls, the unadjusted odds ratio was 0.08. The third case-control study involving residential care center patients did not reveal any protective effect for additional nocturnal supervision.

“This review has highlighted an overall deficiency in the literature base on the effectiveness of a wide range of interventions in the prevention of SUDEP in people with epilepsy,” the authors write.